A previously healthy 26-year-old male is brought to the emergency department due to muscle weakness. He reports mild weakness in his legs that has progressively worsened over a few days to the point that he can barely move his legs. He has some numbness in his legs and his arms feel weak. He has recently recovered from a respiratory infection. 1/5 muscle strength is noted throughout the lower extremities, as well as absent patellar and ankle reflexes. 3 to 4-/5 muscle strength is appreciated throughout his upper extremities. A lumbar puncture is performed, which shows the following: Cell count: 4 cells/mm3, Glucose: 67 mg/dL, Protein: 187 mg/dL Gram stain: no organisms Spirometry is performed, which shows a forced vital capacity of 0.85 L. Which of the following is the best next step in management?

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Neurological System Questions Questions

Question 1 of 5

A previously healthy 26-year-old male is brought to the emergency department due to muscle weakness. He reports mild weakness in his legs that has progressively worsened over a few days to the point that he can barely move his legs. He has some numbness in his legs and his arms feel weak. He has recently recovered from a respiratory infection. 1/5 muscle strength is noted throughout the lower extremities, as well as absent patellar and ankle reflexes. 3 to 4-/5 muscle strength is appreciated throughout his upper extremities. A lumbar puncture is performed, which shows the following: Cell count: 4 cells/mm3, Glucose: 67 mg/dL, Protein: 187 mg/dL Gram stain: no organisms Spirometry is performed, which shows a forced vital capacity of 0.85 L. Which of the following is the best next step in management?

Correct Answer: B

Rationale: The patient's presentation of rapidly progressive weakness, areflexia, and elevated cerebrospinal fluid protein with normal cell count (albuminocytologic dissociation) is classic for Guillain-Barre syndrome (GBS). The forced vital capacity of 0.85 L indicates respiratory failure, necessitating immediate intubation to protect the airway and provide mechanical ventilation. Intravenous immunoglobulin and plasma exchange are treatments for GBS but are secondary to securing the airway in this critically ill patient.

Question 2 of 5

A client with relapsing-remitting multiple sclerosis tells the nurse that even though the primary symptoms of exacerbation are leg spasms and blurred vision, the hardest part is trying to get through the day because of being so tired. Which diagnosis should the nurse identify as a priority for this client?

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 3 of 5

A 71-year-old patient has had PD for 8 years and is currently taking pramipexole 1.5 mg three times a day and carbidopa/levodopa 25/100 mg four times a day. His wife claims that he is complaining of seeing spiders and bugs running across the floor and imaginary children in their house. The first thing to do is:

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 4 of 5

Nurse Thompson is reviewing the neurological assessment of Mr. Johnson, a 70-year-old patient who exhibits tremors and slow movements. She recalls that these symptoms are often linked to a specific neurological disorder characterized by reduced dopamine levels due to the loss of pigmented neurons in the substantia nigra region of the basal ganglia. Which disease does Nurse Thompson recognize as associated with these findings?

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 5 of 5

The change in electrical charge that occurs in a neuron when a nerve impulse is transmitted is known as the:

Correct Answer: A

Rationale: An action potential is the rapid change in electrical charge that occurs in a neuron when a nerve impulse is transmitted. This process involves the depolarization of the neuron's membrane, where sodium ions rush into the cell, followed by repolarization, where potassium ions exit the cell. The action potential is the basis for neural communication and allows signals to travel quickly along the axon to the synapse, where neurotransmitters are released to communicate with other neurons.

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